Adherence to a Mediterranean diet is associated with a significantly lower risk of all major types of stroke among women, according to a large long-term study published on February 4, 2026, in Neurology Open Access, a journal of the American Academy of Neurology. While the findings demonstrate a strong association, researchers caution that the study does not establish a direct causal relationship.
The Mediterranean diet—characterized by high consumption of vegetables, fruits, legumes, whole grains, fish, and healthy fats such as olive oil, along with low intake of red meat, dairy products, and saturated fats—was linked to reduced risks of both ischemic and hemorrhagic strokes. Ischemic stroke, caused by blocked blood flow to the brain, is the most common type, while hemorrhagic stroke results from bleeding in the brain.
The study followed 105,614 women with an average age of 53 years at baseline, all of whom had no prior history of stroke. Participants completed dietary questionnaires and were assigned scores ranging from zero to nine based on how closely they followed the Mediterranean diet. About 30% of participants scored in the highest adherence group, while 13% fell into the lowest category.
Over an average follow-up period of 21 years, 4,083 strokes were recorded, including 3,358 ischemic and 725 hemorrhagic strokes. After adjusting for factors such as smoking, physical activity, and high blood pressure, women with the highest Mediterranean diet scores were found to be 18% less likely to experience any stroke compared with those in the lowest group. The risk reduction was 16% for ischemic stroke and 25% for hemorrhagic stroke.
“These findings add to growing evidence that diet plays a critical role in stroke prevention,” said lead author Sophia S. Wang, PhD, of the City of Hope Comprehensive Cancer Center. She noted that the association with hemorrhagic stroke is particularly noteworthy, as fewer large studies have examined this outcome.
The researchers acknowledged limitations, including reliance on self-reported dietary data, which may be subject to recall bias. Nonetheless, the results underscore the potential importance of dietary patterns in reducing long-term stroke risk and support further research into the biological mechanisms involved.
REFERENCE: Sherzai, A. Z., et al. (2026) Mediterranean Diet and the Risk of Stroke Subtypes in Women.The California Teachers Study. Neurology® Open Access. DOI: 10.1212/WN9.0000000000000062. https://www.neurology.org/doi/10.1212/WN9.0000000000000062
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